Stroke Care in the First Affiliated Hospital of Chengdu Medical College during the COVID-19 Outbreak

Eur Neurol. 2020;83(6):630-635. doi: 10.1159/000513097. Epub 2020 Dec 18.

Abstract

Coronavirus disease-2019 (COVID-19) has become a pandemic disease globally. The First Affiliated Hospital of Chengdu Medical College has adopted telestroke to make stroke care accessible in remote areas. During the period January 2020 to March 2020, there was no COVID-19 case reported in our stroke center. A significant reduction of stroke admission was observed between the ischemic stroke group (235 vs. 588 cases) and the intracerebral hemorrhage group (136 vs. 150 cases) when compared with the same period last year (p < 0.001). The mean door-to-needle time (DNT) and door-to-puncture time (DPT) was 62 and 124 min, respectively. Compared to the same period last year, a significant change was observed in DNT (62 ± 12 vs. 47 ± 8 min, p = 0.019) but not in DPT (124 ± 58 vs. 135 ± 23 min, p = 0.682). A total of 46 telestroke consultations were received from network hospitals. Telestroke management in the central hospital was performed on 17 patients. Of them, 3 (17.6%) patients had brain hernia and died in hospital and 8 (47.1%) patients were able to ambulation at discharge and had a modified Rankin Scale of 0-2 at 3 months. The COVID-19 pandemic impacted stroke care significantly in our hospital, including prehospital and in-hospital settings, resulting in a significant drop in acute ischemic stroke admissions and a delay in DNT. The construction of a telestroke network enabled us to extend health-care resources and make stroke care accessible in remote areas. Stroke education and public awareness should be reinforced during the COVID-19 pandemic.

Keywords: Coronavirus disease-2019; Stroke; Telestroke.

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19*
  • Female
  • Functional Status
  • Hemorrhagic Stroke / therapy*
  • Hospitalization
  • Hospitals
  • Humans
  • Ischemic Stroke / therapy*
  • Male
  • Middle Aged
  • Multi-Institutional Systems / organization & administration
  • Pandemics
  • SARS-CoV-2
  • Stroke / epidemiology
  • Telemedicine / methods*
  • Telemedicine / organization & administration
  • Thrombectomy / statistics & numerical data*
  • Thrombolytic Therapy / statistics & numerical data*
  • Time-to-Treatment / statistics & numerical data*
  • Treatment Outcome